Funding for the kidney-cancer drug Sutent in Wales is under review after concerns were raised over apparent inconsistencies in prescribing.
Some areas approve all applications, while others nearly always decline them, according to a study by the medical director of NHS Wales.
After the rejection of 48 of 73 requests, health minister Edwina Hart has ordered a clinical audit to ensure consistent criteria are applied.
Regional variations in prescribing rates have been found: in Neath Port Talbot and Bridgend, every patient recommended for the drug received it, Cardiff approved only one of 13, while Swansea rejected all 14 applications.
The National Institute for Health and Clinical Excellence (NICE) and the All Wales Medicines Strategy Group have said that Sutent should not be issued on the NHS due to a lack of evidence of its clinical and cost effectiveness.
Decisions are therefore taken by local health boards on whether to fund the drug after considering the evidence for individual patients.
NICE is currently reconsidering its advice and is expected to issue firm guidance by the end of January.
Copyright Press Association 2008